Operating table

ABSTRACT

An operating table structure in which the operating table comprises a plurality of sections adjustable relative to each other, and in which the control means for controlling the adjustment of said adjusting means are arranged on pivot arm means pivotally connected to the upper portion of the operating table structure.

United States Patent Hans-Ulrich Jung Rastatt, Germany May 27, 1968 June15, 1971 Stierlen-Werke Aktiengesellschaft Rastatt, Germany May 27, 1967Germany Inventor Appl. No. Filed Patented Assignee Priority OPERATINGTABLE 7 Claims, 11 Drawing Figs.

11.8. C1. 269/325 Int. Cl A6lg 13/00 Field of Search 269/322- [56]References Cited UNITED STATES PATENTS 2,647,026 7/1953 Shampaine269/325 3,281,14l 10/1966 Smiley 269/325 Primary Examiner-Robert C.Riordon Assistant Examiner-David R. Melton Artomey-Walter BeckerOPERATING TABLE The present invention relates to a surgical operatingtable in which the actuating elements for the adjusting mechanisms arearranged on a pivotal arm the pivot axis of which is locatedapproximately perpendicular with regard to the patient-supporting plane.Y

Modern surgery requiresthat the operating table, in addition topermitting an advantageous placing of-the patient in different positionswithout impeding the movements of the surgeon, also permits an unimpededintraoperativeX-ray possibility for the obtainment of X-ray photographsas well as for the fluoroscopy with X-ray picture amplifying devices.Finally, it is required that the operating table can be actuated fromone central positions which will not interfere with the action of theoperating team.

While these requirements can relatively easily be met with operatingtables which are adjustable purely be means of electric motors,considerable difficulties are, encountered when the adjustments are mademanually or when motor-actuated adjusting means are employed togetherwith mechanical transmission means. These difficulties are due alreadyto the fact that the adjusting and actuating means are limited to acertain location.

Some heretofore known operating tables have a transmission chassis withhandwheel and cranks which are operable from the head end of the tableand which extend to the head end of the supporting surface of the table.This chassis which has proved very advantageous for the stability of thetable and for the mounting of the transmission and the drive thereforinterferes, however, with the X-ray operation so as to make the samepractically impossible in the area of said chassis.

Therefore, operating tables have been developed in which thetransmission chassis is limited to the longitudinal extension of thecentral portion of the table or is placed into the lateral portions ofthe table. However, in order to take the actuating elements out of thecentral portion of the table where theyinterfere with most types ofoperations, arms are required which either only at one table side or onboth table sides, as a rule, lead to the head end. As a result thereof,an area within the thorax range is created which can be X-rayed, butfrequently complications occur in connection with the manipulation ofthe X-ray apparatus. When arranging the arms below thepatient-supporting surface, it was necessary to compromise withundesired limitations concerning the adjustability of the backsupportingportion of the table, whereas the arrangement 'of the arms outside thepatient-supporting area interferes with the action of the surgeon.

Furthermore, operating tables have become known, in which the actuatingelements for the adjusting devices are connected directly to the end ofthe backplate of the table. This arrangement which is favorable as toaccessibility and X- ray operation but is complicated inasmuch as somejoints have to be bridged. Moreover, this arrangement has the drawbackthat the adjusting devices can, in certain positions of the table,hardly be actuated.

All of the heretofore-known arrangements have the additional drawbackthat they are limited to a certain location which interferes with theuniversal employment of such operating tables.

With the generally desired and advantageous arrangement of the actuatingelements at the head end of the table, the actuation is, in connectionwith all operations on the head and neck (for instance in neurosurgery,in the neck, nose and ear surgery, and with the rather frequent strumaoperation, etc.), not impossible but rather difficult and always thereexists the danger of asepsis.

It is, therefore, an object of the present invention to provide anoperating table which will overcome the above-mentioned drawbacks.

It is another object of this invention to provide an operating tablewhich is relatively simple and inexpensive and will assure a universaluse thereof.

These and other objects and advantages of the invention will appear moreclearly from the following specification in connection with theaccompanying drawings, in which:

FIG. 1 diagrammatically illustrates a view of a conventional movableoperating table comprising the features of the present invention.

FIG. 2 is a top view of FIG. 1. FIG. 3 diagrammatically illustrates aview of a stationary motor-driven operating table according to theinvention.

FIG. 4 is a top view ofFlG. 3. FIG. 5 is a section along the line b-b ofFIG. 11 and shows and shows the driving mechanism for a manuallyoperable operation table.

FIG. 6 is a section along the line c-c of FIG. II and shows a portion ofthe drive for inclining the table about the axis B-B.

FIG. 7 is a section along the line d-d of FIG. 5 and shows the couplingmechanism of the central drive.

FIG. 8 is a view in the direction of the arrow e in FIG. 5 and shows theoperating knob on the tilting arm.

FIG. 9 represents a section taken along the line f-f of FIG. 11 andshows a portion of a drive for pivoting the table abou the axis C-C.

FIG. 10 is a section along the line g g of FIG. 11 and shows thetransmitting means for adjusting the portions making u thepatient-supporting part of the operating table.

FIG. 11 is a section along the line a-a of FIG. 5 and shows the drivemechanism of a manually operable operating table.

The operating table according to the present invention, which comprisesa movable or stationary foot section and an upper portion adjustable asto height, is characterized primarily in that the actuating elements forat least some adjusting devices are arranged on a pivotable armpertaining to the upper portion, the pivot axis of said pivotable armbeing approximately vertical when the patient-supporting surface of thetable occupies its horizontal basic position.

Referring now to the drawings in detail and FIGS. 1 and 2 thereof inparticular, the operating table shown therein comprises a supporting orfoot section 1 and an upper portion 2. Connected to the upper portion 2is an arm 3 which is tiltable about a shaft A. The range over which thearm 3 can be pivoted is indicated by the arc B and B and the respectiveend positions are indicated in FIG. 2 by dot-dash lines. The upperportion 2 of the operating table isadapted to be adjusted as to heightby means of corresponding adjusting devices known per se which areusually located within the foot or supporting section 1 and which may beof any standard hydraulic or pneumatic type.

According to FIGS. 1 and 2, the upper portion 2 of the operating tablecomprises a central portion 11 which at the same time may serve astransmission chassis and which carries or forms the seat plate.Furthermore, the upper portion of the operating table comprises thebackplate l2 and the leg plate 13. The central portion 11 is, in amanner known per se and therefore not illustrated, together with theplates 12 and 13 which are linked thereto adapted to be inclined about ahorizontal longitudinal axis of the operating table and about ahorizontal transverse axis of the operating table. In addition thereto,the plates 12 and 13 may be adjusted relative to the central portion 11and relative to each other. If the operating table has furthersubdivisions, also such subdivisions may be adjustable relative to eachother.

As far as these adjustments are effected over adjusting transmissions orduring the operation, the actuating means are mounted on the pivotablearm 3. These adjusting means, according to the particular example shown,comprise a handcrank 31 and a selector lever 32. By means of theselector lever 32, through the intervention of suitable control shaftsand linkage means, the intended transmission for the desired adjustmentis controlled whereupon, by means of the central handcrank 31, theadjustment of the operating table is effected. Instead of thetransmission control, also a lurality of handcranks or handwheels may beprovided which through individual drive shafts, if desired throughhollowshafts, actuate the various adjusting transmissions. If desired, also aplurality of handwheels may be combined with corresponding control meansand also the number of the adjusting transmissions may be selected inconformity with the particular purpose for which the table is intended.The control transmissions may also include means for adjusting theheight of the operatingtable. Instead of providing a handcrank 31, alsoa motor drive may be selected.

If the shaft A, which in the basic position of the operating table isvertical, is so connected to the table that it does not follow theadjustments of said table, the arm 3 will always remain in the selectedposition and has to be pivoted about the shaft A only when X-rays aretaken or during fluoroscopic observations or during operations in thehead area. For fixing the arm 3 in the desired pivotal position,corresponding locking means may be provided which, if desired, may beoperable from the free end of the arm.

If, in conformity with the illustrated embodiment, the pivotal arm 3 isso connected to the transmission chassis II that it follows theadjustment of said chassis, it may occur that the actuating elements 31,32, for instance with great inclinations toward the foot or head end,can be actuated only under difficulties which is always the case whenthe arm is not pivotable. In such an instance, a lateral pivoting willsuffice in order to bring about or restore a favorable operatingposition. Similarly, when the lowering or downward tilting of thebackplate 12 is impeded by arm 3, it is possible to move the arm outofthe way.

Referring now to FIGS. 3 and 4, these figures illustrate an operatingtable according to which by a unilateral protrusion of thepatient-supporting surface a highly satisfactory possibility is realizedfor X-raying the thorax and pelvis area. The patient-supporting partsare in this instance supported by a column head 21 in which a crosshead22 isjournaled for pivoting about the shaft or axis B. The crosshead 22supports the jaws 23 and 23' for pivoting about the axis or shaft C. Thejaws 23 and 23' in their turn form the supports for the central portion(seat plate) 24 of the operating table. Pivotally connected to saidcentral portion 24 are the lower backplate 25 and the upper backplate 26pivotally connected to the backplate 25. In the other direction, thereare pivotally arranged the righthand and left-hand leg plates 27, 27'and 28,28 which can be exchanged for the backplates 25 and 26.

According to the embodiment illustrated in FIGS. 3 and 4, the pivotablearms 3, 3' are respectively connected to the jaws 23, 23'. With a twinarrangement as shown in the drawing, each of the arms 3,3 is pivotableby 180 through the arc B, B which is of importance when, for instanceduring operations on the rectum or during gynecological operations, thebackplates 25, 26 are exchanged for the leg plates 27, 27' and 28, 28

Inasmuch as the embodiment of FIGS. 3 and 4 represents an operatingtable with motoric adjustments, the free end of the arms 3, 3 are notequipped with a manually operable crank but have pushbuttons 33 for theturning on and turning off of the motor. Also in this instance the arms3, 3 are provided with the transmission selector 32 for preselecting thedesired adjustment. If each adjusting transmission has its own drivemotor, the selector 32 is not required and may be replaced bypushbuttons or other electric switches, or the selector may be designedfor electrically controlling the adjusting transmission.

FIGS. 5-11 illustrate by way of example, a manually operable operatingtable adapted to be operated by a centrally located crank 31. Thearrangement also comprises a tiltable arm located on the longitudinalaxis of the table and moving only with the adjustment as to the heightand the transverse inclination of the table about the axis 8-8. Thetable upper portion 2 is by means of screws 10] connected to the footportion 1. The said table upper portion 2 comprises a column head 21having a crosshead 22 pivotally journaled for pivoting about the axisB-B. Mounted in the crosshead 22 on the right and left side are jaws 23and 23 which carry the central portion 24 (FIG. 3) of the operatingtable for supporting the patient.

Pivotally mounted in the crosshead 22 is the head 301 of the tiltabledriving arm 3, said head 301 being held in axial direction by means of aring 302 which engages a groove of the head 301. The ring 302 isconnected to the crosshead 22 by means of screws 303.

In the operating head 304 of the arm 3 there are journaled the hollowdriving shaft 305 and the hollow coupling shaft 306. Connected to theshaft 305 is the manually operable crank 31, while the control member 32is frictionally connected to the shaft 306.

By means of key and groove 309 and 311, the hollow shafts 305 and 306are telescopically connected to the shafts 308 and 310 for reducing thelength of the arm 3. This connection is a power connection.

The shaft 308 and 310 are journaled in the head 301. Mounted on shaft308 is a bevel gear 312 which meshes with the bevel gear 313 in the head301. Connected to shaft 310 is a fork-shaped coupling lever 314 which bymeans of pins 315 engages the grooves ofa coupling sleeve 316 which, inits turn, is connected to the end ofa bolt 317. In said bolt 317 thereare pull-wedge members 318, 319, and 320, resiliently journaled onpivots 321, 322, and 323 in such a way that their engaging portion is,by means of the thrust of springs, pressed outwardly.

Bevel gear 313 is adapted to drive a hollow shaft 324 which is providedwith slots to permit passage and movement of the pull-wedge members.Connected to hollow shaft 324 for rotation therewith are helical gears325 and 326 and the bevel gear 327. When the crank handle 31 is rotated,depending on the member 32, by means of which the coupling lever 314 istilted and the bolt 317 is axially displaced, the respective wedgemembers 318, 319, and 320 engage the transmission wheels 325, 326, 327pertaining thereto which then are rotated by the hollow shaft 324through the intervention of the bevel gear transmission 312,313.

In the particular example shown, the control member 32 occupies itscentral position so that the wedge member 319 engages the groove of thehelical wheel 326. The gear 326 meshes with the gear 328 which ismounted on shaft 329 journaled in the jaw 23. At the other end of shaft329 there is located the helical wheel 330 which, in its turn, mesheswith the helical wheel 331 and is connected to the shaft 332. Shaft 332which is likewise journaled in jaw 23 has its other end provided withdriving means, for instance, the bevel gear 333 which, in a manner knownper se (and therefore not illustrated) conveys the rotational movementto the central supporting member 24 where, by means of suitable drivingelements, the adjustment of the backplates 25, 26, or the leg plates 27,28 is effected. When the control member 32 is adjusted upwardly up toupper abutment 307, the wedge member 320 will, in the manner describedabove, engage the groove of the bevel gear 327 meshing with the bevelgear 334. The bevel gear 334 is mounted on a shaft 335 in the crosshead22 which shaft at its other end carries the worm 336. This worm 336meshes with the worm wheel 337 which is arranged on shaft 338 in columnhead 21 for power transfer. At the lower end of shaft 338 there isarranged the spur gear 339 meshing with the spur gear 340 which isconnected to the end of the worm 341. The worm 341 arranged in thecolumn head 21 meshes with the worm wheel 342 which latter is threadedlyconnected to the bearing pivot of the crosshead 22 in a centering mannerby means of screws 343. In this way, when turning the handcrank 31 thecrosshead 22 is tilted about the axis B-B while the driving arm 3 whichis connected to the crosshead 22 follows this tilting movement.

When the control member 32 is adjusted downwardly up to the lowerabutment 307, the wedge member 318 engages the groove of the helicalgear 325 which, in its turn, meshes with the helical wheel 344. On theshaft 345 journaled in the crosshead 22 are arranged on one hand thehelical gear 344 and on the other hand the worm 346. Worm 346 mesheswith helical wheel 347 which is connected to the driving stud of worm348 for power transmission. The worm 348 meshes with the worm wheel 349which is threadedly connected in a centering manner by means of screws350 to the bearing stud of the jaw 23. It will thus be evident that whenturning the handcrank 31 the jaw 23 and the part 24 are pivoted aboutthe axis C-C.

The jaw 23 forming an additional bearing means is rigidly connected tothe jaw 23 by means of the central member 24. When tilting about theaxis C-C, the arm 3 does not take part in this tilting movement. Itwould do so only if arm 3 were, with a correspondingly changedtransmission, mounted on the jaw 23 or 23' or the patient-supportingsurface. In this instance, the arm 3 would tilt when a tilting action iscarried out about the axis C-C and would also take part in the tiltingabout the axis B-B. If it were desired that the driving arm 3 carry outno tilting movements, but only adjusting movements of the table as toheight, the driving arm 3 would have to be mounted on the foot part 1with the transmission changed accordingly.

From FIG. 5 it will be obvious that the actuation of the adjustingdevices by'means of the handcrank 31 in any desired tilting position ofthe arm 3 will be possible. This is due to the fact that the tiltingaxis A of the head 301 coincides with the axis of the bevel gear 313.Similarly, the control of the wedge members in each tilting position ispossible by means ofa control member 32 because the coupling sleeve 313is rotatably mounted on the bolt 317, the axis of which coincides withthe pivot axis A of arm 3.

The arrangement of the pivot shafts A, A is in addition to the desiredpivoting range, also determined by the structural possibilities. As arule, the arrangement in a table portion which follows entirely orpartially the adjustments, greatly facilitates the structural solution.

If the arm 3 in its pivoted out position protrudes too far beyond thetable, the arm may be composed of telescopic sections to permit acorresponding shortening of the arm and also a corresponding extensionof the arm for special purposes.

The pivotal arm for the actuating means pertaining to the adjustingdevices results in a simple manner in the following advantages:

1. Unimpeded X-raying by pivoting the arm out of the range of theX-rays.

2. Easy actuation of the actuating means by pivoting the arm to itsrespective most favorable actuating position.

3. Optimum working conditions for the surgeon by removing the actuatingmeans for the adjusting devices out of the operating range.

It is to be understood that the embodiments referred to above are merelyexamples and that numerous modifications are possible within the scopeof the appended claims.

What I claim is:

1. An operating table structure which includes: supporting means, anupper portion forming the patient receiving and supporting tablesupported by and vertically adjustable relative to said supportingmeans, said table including a plurality of sections adjustable relativeto each other, adjusting means operatively connected to at least one ofsaid sections for selectively adjusting the same, arm means pivotallyconnected to said upper portion and pivotable about a vertical axis whenthe top surface of said patient-supporting table is located in anapproximately horizontal plane, and mechanical table-actuating controlmeans including a handcrank and a selector lever respectivelymechanically operatively connected to said adjusting means and supportedby said arm means.

2. A structure according to claim 1, in which the pivot axis of said armmeans is the axis of a shaft positioned to determine arc range in whichsaid arm means is pivotable and moveable only in vertical directionupwardly and downwardly.

3. A structure according to claim 1, in which the pivot axis of said armmeans is the axis of a shaft so mounted on the operating table structureas to change its position in conformity with the inclination of at leastone of said adjustable sections changeable alternately about onlylongitudinal, only transverse and both lon itudinal and transverse axes.

4. A structure accor mg to claim 1, in which the pivot axis of said armmeans coincides with and is located approximately in the longitudinalcentral plane of said patient supporting table.

5. A structure according to claim 1, in which said arm means comprisestwo arms respectively pivotally supported by said operating tablestructure with the pivot axes thereof respectively located to the rightand left on opposite sides of and substantially symmetrically to thelongitudinal central plane of said patient supporting table.

6. A structure according to claim 5, in which part of thetable-actuating control means is supported by one of said arms and othertable-actuating control means are supported by the other one of saidarms.

7. A structure according to claim 1, in which said pivotable arm meansare composed ofsections individually telescopically interengaging eachother for selectively shortening and extending said arm means.

1. An operating table structure which includes: supporting means, anupper portion forming the patient receiving and supporting tablesupported by and vertically adjustable relative to said supportingmeans, said table including a plurality of sections adjustable relativeto each other, adjusting means operatively connected to at least one ofsaid sections for selectively adjusting the same, arm means pivotallyconnected to said upper portion and pivotable about a vertical axis whenthe top surface of said patient-supporting table is located in anapproximately horizontal plane, and mechanical table-actuating controlmeans including a handcrank and a selector lever respectivelymechanically operatively connected to said adjusting means and supportedby said arm means.
 2. A structure according to claim 1, in which thepivot axis of said arm means is the axis of a shaft positioned todetermine arc range in which said arm means is pivotable and moveableonly in vertical direction upwardly and downwardly.
 3. A structureaccording to claim 1, in which the pivot axis of said arm means is theaxis of a shaft so mounted on the operating table structure as to changeits position in conformity with the inclination of at least one of saidadjustable sections changeable alternately about only longitudinal, onlytransverse and both longitudinal and transverse axes.
 4. A structureaccording to claim 1, in which the pivot axis of said arm meanscoincides with and is located approximately in the longitudinal centralplane of said patient supporting table.
 5. A structure according toclaim 1, in which said arm means comprises two arms respectivelypivotally supported by said operating table structure with the pivotaxes thereof respectively located to the right and left on oppositesides of and substantially symmetrically to the longitudinal centralplane of said patient supporting table.
 6. A structure according toclaim 5, in which part of the table-actuating control means is supportedby one of said arms and other table-actuating control means aresupported by the other one of said arms.
 7. A structure according toclaim 1, in which said pivotable arm means are composed of sectionsindividually telescopically interengaging each other for selectivelyshortening and extending said arm means.